الفهرس 
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Abstract
In this study fifty two patients of ASA I and II aged between 18 and 65 years old of both gender were scheduled for elective laparoscopic cholecystectomy under general anesthesia in Gastroenterology Center at Mansoura University. Exclusion criteria were Patient’s refusal to participate in the study, uncontrolled renal, hepatic or endocrine disease, coagulation disorders, allergy to any medication used in the study, body mass index >40 kg/m2, local skin infection and sepsis at site of the block or any psychiatric disorders. Patients were divided into two groups (twenty six patients in each group): Peritoneal block group (group P) :Patients received two intra-peritoneal injections: the first immediately after pneumo-peritoneum and the second at the end of the surgery, each injection consists of 2 mg/kg lidocaine , 25mg/kg magnesium sulfate [70] and 1/200 000 epinephrine completed with normal saline to a total volume of 30 ml . Erector spinae plane block group (group E): Patients received bilateral ESPB ,each consists of 2 mg/kg lidocaine , 150 mg magnesium sulfate [71] and 1/200 000 epinephrine completed with normal saline to a total volume of 30 ml . Visual analogue scale application was explained to all patients in the preoperative visit. Hemodynamic data as heart rate and mean arterial pressure of the patient were recorded basal and every 10 min intraoperative till the end of surgery and at 0, 30 minutes, 60 minutes, 2 , 4 , 8 , 12, 16 ,24 hours postoperatively. Preoperative and one hour postoperative serum cortisol levels were assessed and compared in both groups. Visual analogue score and shoulder pain were recorded at 0, 30 minutes, 60 minutes, 2 , 4 , 8 , 12, 16 ,24 hours postoperatively. Also, time of first analgesic request , total morphine consumption and any postoperative nausea and vomiting , tinnitus or circumoral numbness occurring in 1st 24 h were recorded. Time to return of bowel habit as a recovery variable also was recorded . The results proved that ESPB provided better quality of analgesia , less postoperative opioid consumption and better recovery variables than PB after laparoscopic cholecystectomy.